Published online December 1, 2008
PEDIATRICS Vol. 122 No. 6 December 2008, pp. e1186-e1192 (doi:10.1542/peds.2008-0292)
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ARTICLE

At What Age Do Children Start Taking Daily Asthma Medicines on Their Own?

Joan K. Orrell-Valente, PhDa,b, Leah G. Jarlsberg, BAa, Laura G. Hill, PhDc and Michael D. Cabana, MD, MPHa,d,e

Departments of a Pediatrics
b Psychiatry
d Epidemiology and Biostatistics
e Philip Lee Institute of Health Policy Studies, University of California, San Francisco, California
c Department of Human Development, Washington State University, Seattle, Washington

OBJECTIVE. Use of daily controller medications is a critical task in management of persistent asthma. Study aims were to examine (1) the association between child age and extent of daily controller-medication responsibility in a sample aged 4 to 19 years, (2) parent, child, and disease predictors of child daily controller-medication responsibility and overall daily controller-medication adherence, and (3) the association between child daily controller-medication responsibility and overall daily controller-medication adherence.

METHODS. We conducted a cross-sectional telephone survey of 351 parents of children who were prescribed daily controller medication. Children's mean age was 10.4 years; 61.5% were male, and 88.1% were white. Parents provided all data, including an estimate of the percentage of child and parent daily controller-medication responsibility. Daily controller-medication adherence was measured as parents' report of percentage of daily doses taken per doses prescribed in a typical week. We used multivariate linear regression to determine associations between parent race/ethnicity, education, income, number of dependents, child age, gender, years since diagnosis, parent perception of symptom severity and control, and dependent variables (child daily controller-medication responsibility and daily controller-medication adherence). We also examined associations between child daily controller-medication responsibility and daily controller-medication adherence.

RESULTS. Child daily controller-medication responsibility increased with age. By age 7, children had assumed, on average, almost 20% of daily controller-medication responsibility; by age 11, ~50%; by age 15, 75%; and by age 19, 100%. In multivariate models, child age and male gender remained significantly associated with child daily controller-medication responsibility, and child's age and parents' race/ethnicity remained significantly associated with daily controller-medication adherence.

CONCLUSIONS. Clinicians may need to screen for child daily controller-medication management and include even young children when educating families on the use of asthma medications and other key asthma-management tasks.

Key Words: daily asthma medications • asthma self-management • children • parents • adherence

Abbreviations: DCM—daily controller medication

Accepted Sep 2, 2008.


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